| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 25 Nov 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 29 Nov 1911 |
| If rejected, why? | |
| Birthplace as written | Hanover, Germany |
| Modern country | Germany |
| Age on application | 68 |
| Age on arrival in Australia | 7 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Jan 1880 |
| Name of ship | Washington |
| Voyage | Washington (1880-01-01) |
| Address in Australia | Weke St. Claraville Mt Gambia |
| Address State | South Australia |
| Time at address | 36 years |
| Previous address 1 | Tununda |
| Address State | South Australia |
| Time at address | 20 years |
| Previous address 2 | Springtown |
| Address State | |
| Time at address | 5 years |
| Married | Widow | |
| Children | Yes | 5: 3 girls and 2 boys. In Australia, but for a daughter in South Africa and a son in England |
| Name of reference | Peter Rudy |
| Occupation of reference | Officer of Police, South Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |